Patient Threatens Staff with Multiple Weapons


Police have charged a man with inducing panic, assault, aggravated menacing and three counts of carrying concealed weapons for allegedly threatening Bethesda North Hospital employees with bear repellant, a gun and a walker. Steven Wuest reportedly struck a nurse with a can of bear spray, injuring her hand, before threatening to spray other staffers with the bear repellant. After trying to hit medical personnel with his walker, he then threatened to shoot them with a loaded .22-caliber pistol. Hospital security was able to restrain the suspect until police arrived at the scene. Officers seized a .38-caliber pistol, two .22-caliber pistols, ammo, bear repellant and other items from his duffel bag. He is scheduled to appear in court on Nov. 12.


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ED Violence: Not Just Part of the Job Violence in the health care setting is a disturbing reality and a growing problem. The unique environment of the emergency department, where all comers are cared for and acuity and emotions run high, lends itself to a higher incidence of patient aggression than most other hospital departments. ACEP policy states that emergency physicians have a duty to oppose violence and to "protect themselves, staff, and patients from violence." As a first step, all emergency department staff, especially physicians, should be trained in techniques that can keep both patients and staff safe. The most important technique is using an open body posture and listening to the patient’s concern. Additionally, the staff should be aware of a person’s body language and learn to diffuse a situation before it gets violent. If the person has a reasonable request, you or the staff member should try to resolve the issue in a non-confrontational way. In extreme situations, the patient may be briefly restrained and then allowed to emotionally recover while de-escalation techniques are continued. Some emergency departments rely on professional outsourcing to provide violence prevention training for all staff. Emergency physicians must resist the idea that violence is expected and to be tolerated. Unfortunately, violence will never be eliminated from the emergency department, but being aware of the problem, learning violence de-escalation techniques and having an expectation to work in a violence-free environment are a start.


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